NPI | 1003343278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX T6930) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T6930) |
Enumeration Date | 2017-05-17 |
Last Update Date | 2023-07-06 |